The Care Quality Commission
  • Mental Health
  • Independent mental health service

Cygnet Lodge

Overall: Good read more about inspection ratings

2a Sandown Road, Sutton in Ashfield, Mansfield, Nottinghamshire, NG17 4LW (01623) 669028

Provided and run by:
Cygnet Learning Disabilities Midlands Limited

All Inspections

14 to 15 August 2019

During a routine inspection

We rated Cygnet Lodge as good because:

  • The environment was clean. The wards had enough nurses and doctors. Staff assessed and managed risks well. They managed medicines safely and followed good practice with respect to safeguarding.
  • Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They provided a range of treatments suitable to the needs of the patients cared for in a mental health rehabilitation ward and in line with national guidance about best practice. Staff engaged in clinical audit to evaluate the quality of care they provided.
  • The service included or had access to the full range of specialists required to meet the needs of patients at the hospital. The manager ensured these staff received training, supervision and appraisal. The staff worked well together as a multidisciplinary team and with those outside the hospital who would have a role in providing aftercare.
  • Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
  • Staff treated patients with compassion and kindness, respected their privacy and dignity, and understood the individual needs of patients. They actively involved patients and families and carers in care decisions.
  • Staff planned and managed discharge well and liaised well with services that would provide aftercare. As a result, discharge was rarely delayed for other than a clinical reason.
  • The service worked to a recognised model of mental health rehabilitation. It was well led, and the governance processes ensured that ward procedures ran smoothly.

However:

  • Staff did not fully complete observation records or ensure hourly observations were varied within the hour. Observations should be at irregular intervals in a pattern which cannot be predicted.
  • Staff did not always record the distribution of bladed razors to patients.
  • The service did not always provide weekend activities for patients
  • The provider should ensure the governance and oversight of the observation policy and the implementation into everyday practice.

27 April and 3-4 May 2016

During a routine inspection

We rated Cambian Lodge as good because:

  • The provider assessed the risks presented by the environment such as blind spots and ligature points, and took appropriate action to reduce them.
  • The unit had adequate staffing levels. Staff were up-to-date with most of their mandatory training and they received annual appraisals and regular supervision.
  • Staff were committed to the least restrictive approaches to managing challenging behaviour such as de-escalation (calming down).
  • Care records were comprehensive and contained up-to-date risk assessments, and robust care plans that covered patients’ physical and mental health needs. Staff fully involved patients and their relatives in assessment and care planning. Records and discussions showed that staff assessed capacity on a decision-specific basis.
  • The provider complied with the relevant national institute of health and care excellence (NICE) guidelines, and offered a range of therapies in line with the acquired brain injury pathway. The provider’s model of care focused on recovery and rehabilitation, and incorporated a positive risk-taking approach.
  • Most family members gave positive feedback about Cambian Lodge and mentioned improvements they saw in their relatives since their admission.
  • All patients received a welcome pack of useful items on admission and had access to a fund to purchase items for their room.
  • The chef cooked food each day taking into account the patients’ specific needs and preferences, and patients could also cook for themselves.
  • Staff actively sought opportunities for patients to participate in community-based activities of their choice.
  • The provider had a robust incident reporting process that led to actions and lessons learned for the whole organisation.
  • There was good morale among staff and they felt valued and supported by all the managers.

However:

  • The compliance rate for Mental Health Act, Mental Capacity Act and Deprivation of Liberty Safeguards training was low (44%).
  • The unit had not fully complied with their complaints procedure in the past.
  • Not all care plans had dates on them. This meant it was difficult to see when staff wrote them and when they were due for review.
  • Patient involvement was not always evident in care records.

11 June 2013

During a routine inspection

We used a number of different methods to help us understand the experiences of patients residing at the the hospital. We looked at records. We utilised the service user satisfaction survey for 2013 and also spoke with one patient. We also spoke with the registered manager and three support staff.

We found that patients enjoyed the meals provided at the hospital. They were also offered a choice of food and drinks and received advice on nutrition and diet as required.

We found that the premises were maintained to a high standard and records showed that one hundred per cent of patient's felt safe and comfortable living at the hospital.

We found that support staff received a comprehensive induction programme when they commenced employment at the hospital. They were also provided with on-going training opportunities pertinent to their roles and responsibilities. A patient also told us that in their opinion the support staff were suitably qualified and felt they were effective in performing their duties.

We found that a complaints procedure was on display throughout the hospital and documentation showed that one hundred per cent of patients were aware of how to make a complaint.

22 October 2012

During a routine inspection

Patients told us they were satisfied with the quality of service provision and did not express any concerns whatsoever. They told us that the staff employed at the hospital would always respect their wishes and felt their views and opinions were valued. They also told us that they were satisfied with the social activities provided within the hospital and within the broader community.

A relative of a patient told us that they were extremely satisfied with the quality of service provision. 'I just cannot believe the change in my son. It's an excellent service that's tailored to his needs,' and,' The staff are all excellent, I cannot fault the service in any way.'

We found that systems were in place to provide the support staff with comprehensive details about patients needs and preferences in relation to the support they received. We also found that the support plans examined on the day of our inspection were very well organised.

We found that the organisation had adhered to an effective recruitment process to ensure suitable staff were employed at the hospital. We also found that the support staff had received a thorough training package to ensure they were competent and confident in performing their duties.

We found that effective quality auditing procedures were undertaken to monitor the quality of service provision and patients and their relatives were encouraged to contribute to the auditing process.